Impact of resistance mutations on efficacy of dolutegravir plus rilpivirine or plus lamivudine as maintenance regimens: a cohort study.

Objectives: The aim of this study was to evaluate the impact of resistance mutations on efficacy of dolutegravir-based two-drug regimens (2DR).

Methods: Virologically suppressed patients with HIV-1 switching to dolutegravir + lamivudine or rilpivirine or to a dolutegravir-based three-drug regimen (3DR) with pre-baseline genotype were selected. Virological failure (VF) was defined as one HIV-RNA viral load (VL) >200 cps/mL or two consecutive VL >50 cps/mL; treatment failure (TF) was defined as VF or treatment discontinuation (TD).

Discordant Liver Fibrosis Predictors in Virologically Suppressed People Living with HIV without Hepatitis Virus Infection.

Severe liver fibrosis (LF) is associated with poor long-term liver-related outcomes in people living with HIV (PLWH). The study aimed to explore the prevalence and predictors of LF and the concordance between different non-invasive methods for the estimation of LF in HIV-infected individuals without hepatitis virus infection. We enrolled PLWH with HIV-1-RNA <50 copies/mL for >12 months, excluding individuals with viral hepatitis.

Use of miltefosine in a patient with mucosal leishmaniasis and HIV-coinfection: a challenge in long-term management.

The management of mucosal leishmaniasis in immunocompromised patients is not standardized and limited data are available on the use of miltefosine for treatment and secondary prophylaxis. We describe a case of mucosal leishmaniasis in an HIV-coinfected patient treated with miltefosine due to a severe allergic reaction to liposomal amphotericin B.

Non-granulomatous cerebellar infection by Acanthamoeba spp. in an immunocompetent host.

Acanthamoeba spp. is a free-living amoeba, frequently involved in keratitis by contact lens in immunocompetent hosts. Anecdotal reports associate Acanthamoeba spp.

Accumulation of HIV-1 drug resistance in patients on a standard thymidine analogue-based first line antiretroviral therapy after virological failure: implications for the activity of next-line regimens from a longitudinal study in Mozambique.

Background: We describe the accumulation of HIV-1 drug resistance and its effect on the activity of next-line components in patients with virological failure (HIV-1 RNA >1000 copies/mL) after 1 year (t1) of first-line antiretroviral therapy (ART) not switching to second-line drugs for one additional year (t2) in low-middle income countries (LMIC).

Methods And Results: We selected 48 patients from the DREAM cohort (Maputo, Mozambique); their median pre-ART CD4+ cell count was 165 cells/μl. At t1 patients were receiving ART since a median of 12.

Seroprevalence of hepatitis E virus (HEV) infection in blood donors and renal transplant recipients: a retrospective study from central Italy.

Autochthonous hepatitis E virus (HEV) is an emerging health issue in developed countries and is thought to be a porcine zoonosis; its spread is underestimated and there is concern about the possibility of chronic infection in immunosuppressed patients; HEV transmission through blood has also been demonstrated. We conducted a retrospective study (2007-2013) on HEV seroprevalence using stored serum samples from 132 blood donors and 118 renal transplant recipients living mainly in central Italy. Anti-HEV IgG was positive in 12/132 (9.

Petechial rash associated with Parvovirus B19 in children: case report and literature review.

Human Parvovirus B19 (B19V) infection usually causes erythema infectiosum (EI). In recent decades, several uncommon exanthems have been described in association with B19V. Recently, haemorrhagic manifestations such as purpuric-petechial rash have been reported.

Imported dengue fever in Tuscany, Italy, in the period 2006 to 2012.

This report focuses on epidemiological and clinical features of dengue fever (DF) in Tuscany (Italy) between 2006 and 2012. Sixty-one DF cases were diagnosed, 32 of which were in the period of Aedes albopictus activity. Some clinical (arthralgia/myalgia, nausea/vomiting, and skin rash), laboratory (leukopenia and thrombocytopenia), and epidemiological characteristics (travel in a continent other than Africa) significantly distinguished DF cases from other febrile illnesses.

Five-year retrospective Italian multicenter study of visceral leishmaniasis treatment.

The treatment of visceral leishmaniasis (VL) is poorly standardized in Italy in spite of the existing evidence. All consecutive patients with VL admitted at 15 Italian centers as inpatients or outpatients between January 2004 and December 2008 were retrospectively considered; outcome data at 1 year after treatment were obtained for all but 1 patient. Demographic characteristics, underlying diseases, diagnostic procedures, treatment regimens and outcomes, as well as side effects were recorded.

HCMV infection in renal transplant recipients: a retrospective cohort study.

Human Cytomegalovirus (HCMV) represents the most common viral complication affecting solid organ transplant recipients (SOTRs) and its management is still debated. This study analyzes the association between HCMV infection and renal transplant recipients' outcomes. From January 2008 through December 2009, 97 consecutive renal transplant recipients were retrospectively studied.

Large oligoclonal outbreak due to Klebsiella pneumoniae ST14 and ST26 producing the FOX-7 AmpC β-lactamase in a neonatal intensive care unit.

A large outbreak caused by expanded-spectrum cephalosporin-resistant Klebsiella pneumoniae (ESCRKP) was observed in a neonatal intensive care unit (NICU) in central Italy. The outbreak involved 127 neonates (99 colonizations and 28 infections, with seven cases of sepsis and two deaths) over a period of more than 2 years (February 2008 to April 2010). Characterization of the 92 nonredundant isolates that were available for further investigation revealed that all of them except one produced the FOX-7 AmpC-type β-lactamase and belonged to either sequence type 14 (ST14) or ST26.

[Which screening for Leishmania infantum in asymptomatic blood donors?].

Leishmaniasis is a protozoan infection endemic in Italy with a greatly underestimated prevalence. The recent documentation of parasitaemia in blood donors is a cause of concern for blood safety. Because there is no screening against leishmania, we performed a study to assess the presence of protozoa in blood donors of Siena district (Tuscany) during the seasonal activity of the vector.

Toscana virus epidemiology: from Italy to beyond.

Toscana virus (TOSV) is an arthropod-borne virus which is transmitted to humans by Phlebotomus spp sandflies. Infection is the cause of brain injuries, such as aseptic meningitis and meningoencephalitis, in Italy mainly during the summer. More recently some unusual clinical manifestations due to TOSV with severe sequelae, such as ischemic complications and hydrocephalus, have been reported.

Dicrocoelium dendriticum: a true infection?

Dicrocoelium dendriticum is a liver parasite of ruminants. Humans are occasionally infected by ingestion of intermediate hosts. We report a rare case of dicrocoeliasis in a 55-year-old woman who presented with eosinophilia and elevated bilirubin.

Sternoclavicular joint infection in an adult without predisposing risk factors.

Septic arthritis of the sternoclavicular joint (SCJ) is an uncommon condition and it has been associated with numerous predisposing factors. We describe a rare case of SCJ infection due to Staphylococcus aureus in an adult without known underlying predisposing conditions and in which recovery was achieved with medical therapy alone.

Outbreak and persistence of Chlamydia pneumoniae infection in an Italian family.

We describe an outbreak of familial infection of Chlamydia pneumoniae, an etiological agent for respiratory tract infections. In a family member detection of C. pneumoniae on a pharyngeal swab by polymerase chain reaction was positive until four months after the onset of symptoms, despite a course of antibiotics known to be effective against Chlamydia species